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The ACC/AHA 2013 pooled cohort equations compared to a Korean Risk Prediction Model for atherosclerotic cardiovascular disease

 Keum Ji Jung  ;  Yangsoo Jang  ;  Dong Joo Oh  ;  Byung-Hee Oh  ;  Sang Hoon Lee  ;  Seong-Wook Park  ;  Ki-Bae Seung  ;  Hong-Kyu Kim  ;  Young Duk Yun  ;  Sung Hee Choi  ;  Jidong Sung  ;  Tae-Yong Lee  ;  Sung hi Kim  ;  Sang Baek Koh  ;  Moon Chan Kim  ;  Hyeon Chang Kim  ;  Heejin Kimm  ;  Chungmo Nam  ;  Sungha Park  ;  Sun Ha Jee 
 ATHEROSCLEROSIS, Vol.242(1) : 367-375, 2015 
Journal Title
Issue Date
Adult ; Aged ; Area Under Curve ; Asian Continental Ancestry Group* ; Atherosclerosis/diagnosis ; Atherosclerosis/ethnology* ; Chi-Square Distribution ; Decision Support Techniques* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; ROC Curve ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Sex Factors ; Time Factors
Atherosclerotic cardiovascular disease ; Cohort study ; Prediction ; Validation
BACKGROUND AND AIMS: To evaluate the performance of the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Pooled Cohort Equations in the Korean Heart Study (KHS) population and to develop a Korean Risk Prediction Model (KRPM) for atherosclerotic cardiovascular disease (ASCVD) events. METHODS: The KHS cohort included 200,010 Korean adults aged 40-79 years who were free from ASCVD at baseline. Discrimination, calibration, and recalibration of the ACC/AHA Equations in predicting 10-year ASCVD risk in the KHS cohort were evaluated. The KRPM was derived using Cox model coefficients, mean risk factor values, and mean incidences from the KHS cohort. RESULTS: In the discriminatory analysis, the ACC/AHA Equations' White and African-American (AA) models moderately distinguished cases from non-cases, and were similar to the KRPM: For men, the area under the receiver operating characteristic curve (AUROCs) were 0.727 (White model), 0.725 (AA model), and 0.741 (KRPM); for women, the corresponding AUROCs were 0.738, 0.739, and 0.745. Absolute 10-year ASCVD risk for men in the KHS cohort was overestimated by 56.5% (White model) and 74.1% (AA model), while the risk for women was underestimated by 27.9% (White model) and overestimated by 29.1% (AA model). Recalibration of the ACC/AHA Equations did not affect discriminatory ability but improved calibration substantially, especially in men in the White model. Of the three ASCVD risk prediction models, the KRPM showed best calibration. CONCLUSIONS: The ACC/AHA Equations should not be directly applied for ASCVD risk prediction in a Korean population. The KRPM showed best predictive ability for ASCVD risk.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Kimm, Heejin(김희진) ORCID logo https://orcid.org/0000-0003-4526-0570
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Jung, Keum Ji(정금지) ORCID logo https://orcid.org/0000-0003-4993-0666
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
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